Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2021)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2176632 Name: ANURAG MISHRA
  Address: P27A, ISWAR MITRA ROAD, BEHALA
Telephone No.: Mobile no: 8648930052
E-mail: anurag.sengupta2002@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 427336576
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176632 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
  Dossier ID: DNS2176632
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: ANURAG MISHRA
Mother's Name: RATNABALI MISHRA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 07 Apr 2002 Nationality: INDIAN
Place of Birth: KOLKATA Personal Identification Mark: MOLE ON RIGHT SIDE OF LOWER OBLIQUES
Blood Group: A + Address for Communication: P27A, ISWAR MITRA ROAD, BEHALA
State: West Bengal Country: India
Pin: 700034 City/District: KOLKATA
Mobile no: 8648930052 Telephone No. with STD code:
Aadhar Card No:243627082837 E-mail: anurag.sengupta2002@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: RATNABALI MISHRA Relationship with candidate: MOTHER
Parents Date of Birth: 10 May 1976 Parent's/Guardian's Occupation/Designation: TEACHER
   
Office Address:
   
Address: P15 MITRA COLONY, BEHALA
Country: India State: West Bengal
City/District: KOLKATA Pin: 700034
Tel: Mobile no.: 9051160622
Fax: Email: ratnabali.mishra@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: ISCE Board: ISCE
School: PUROSHOTTAM BHAGCHANDHIKA ACADEMIC SCHOOL School: PAILAN WORLD SCHOOL
City: KOLKATA City: KOLKATA
English %: 70 Board Roll No./Seat No.:
Aggregate Percentage: 72 School/College Code:
  Centre code:
  Address of School/College: Plot B 187-206 Phase III Bengal Pailan Park, Joka, Kolkata, West Bengal 700104
  Pin: 529596
  Contact Nos:
  Email: admission@pailanworldschool.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
Sports & Extra Curricular Activities:
Achievements in Sports and Extra Curricular Activities
MONTH / YEAR (MM/YYYY) SPORT/ACTIVITY LEVEL OF PARTICIPATION POSITION
01/2020 ATHELETICS INTER SCHOOL 1ST
12/2011 DRAMA INTER SCHOOL 1ST
01/2019 ATHELETICS INTER HOUSE 3RD
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: BODYBUILDING AND BOOSTING MY GENERAL KNOWLEDGE
Why do you wish to join TMI?: BECAUSE IT IS ONE OF THE RENOWNED INSTITUTIONS IN INDIA IMPARTING EXCELLENCY IN THE FIELD OF EDUCATION
What are your hobbies?: FITNESS
What are your strengths?: DEDICATION, PATIENCE AND CREATIVITY
What are your weaknesses?: EMOTIONAL
How do you intend to meet the expenses of this program?: Bank Loan
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

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Date ________________

 
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